Vitamin A is essential for normal immune function and has shown promise for treatment of different infectious diseases in children. The purpose of the project is to determine whether periodic, oral vitamin A supplementation reduces morbidity and mortality for HIV-infected children in sub-Saharan Africa. The goals of the project are being met through a randomized, double-masked, controlled clinical trial of oral vitamin A supplementation, 60 mg retinol equivalent, every three months for HIV-infected children from 12 to 36 months of age. The project is collaboration between Makerere University and the Johns Hopkins University at the Mulago Hospitals in Kampala, Uganda. The project has involved HIV screening of 23,439 women, identification of 3,751 HIV-infected women, and HIV screening of 1241 infants. The project has enrolled 300 HIV-infected children and is in-progress, and children are scheduled to reach 36 months of age by January 2002. Interim analysis shows that groups appear to be similar at baseline (with different characteristics measured at different ages). The application notes a trend in possible mortality benefit to the children receiving vitamin A. The study is being reviewed annually by a data and safety monitoring committee. In this competing continuation application, it is proposed to complete the clinical trial, laboratory studies, and data analysis over the next 3 years. If vitamin A supplementation is shown to reduce morbidity and mortality for HIV-infected children, this would be an appropriate, low-cost (8 cents for capsules per year), safe, and widely applicable intervention to increase survival for HIV-infected children in developing countries.